Lung Diseases and Detoxification Quiz
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Questions and Answers

What enzyme family is responsible for the detoxification of a wide range of electrophilic compounds in the human lung?

  • Epoxide hydrolases
  • UDP-glucuronyltransferases
  • Glutathione S-transferases (correct)
  • Cytochrome P450 enzymes
  • Which of the following is NOT an obstructive lung disease?

  • Bronchiectasis
  • Fibrosis (correct)
  • Emphysema
  • Chronic bronchitis
  • What is a primary characteristic of the exudative phase of ARDS?

  • Release of pro-inflammatory cytokines (correct)
  • Increased surfactant production
  • Decreased neutrophil influx
  • Increased endothelial cell barrier function
  • What is the primary cause of cyanosis?

    <p>Deoxygenated blood circulating through the skin (D)</p> Signup and view all the answers

    Which type of lung disease is characterized by impaired airflow?

    <p>Obstructive (A)</p> Signup and view all the answers

    Which of the following is NOT a direct cause of lung injury that can lead to ARDS?

    <p>Blood transfusions (B)</p> Signup and view all the answers

    Which of the following CYP enzymes is known to be expressed in human lung tissue?

    <p>All of the above (D)</p> Signup and view all the answers

    What is the main symptom associated with the proliferative phase of ARDS?

    <p>Thickening of the alveolar capillaries (A)</p> Signup and view all the answers

    The interaction of BP-7,8-diol-9,10-epoxide with DNA is an example of:

    <p>Covalent binding (D)</p> Signup and view all the answers

    Which of the following is NOT a phase II enzyme involved in the detoxification of metabolites in the lung?

    <p>Cytochrome P450 enzymes (A)</p> Signup and view all the answers

    What does the term 'hypoxemia' refer to in the context of ARDS?

    <p>Decreased oxygen content in the blood (A)</p> Signup and view all the answers

    What is the role of NADPH-cytochrome P450 reductase in the detoxification process?

    <p>Provides electrons for the reduction of oxygen (C)</p> Signup and view all the answers

    Which phase of ARDS is characterized by increased collagen deposition?

    <p>Fibrotic (C)</p> Signup and view all the answers

    What is the primary function of IgE in the context of allergic reactions?

    <p>Binding to mast cells and basophils causing the release of inflammatory mediators. (D)</p> Signup and view all the answers

    Which of the following cell types is NOT a major site of xenobiotic-metabolizing CYP enzyme expression in the lung?

    <p>Type I pneumocytes (D)</p> Signup and view all the answers

    Which symptom is NOT typically associated with ARDS?

    <p>Increased urine output (A)</p> Signup and view all the answers

    What is the probability of a child inheriting two copies of the mutant CFTR gene if both parents are carriers of the mutation?

    <p>25% (B)</p> Signup and view all the answers

    What is the primary function of cilia in the airways?

    <p>To transport mucus out of the airways (D)</p> Signup and view all the answers

    What is the most common mutation of the CFTR gene in Caucasians?

    <p>ΔF508 (B)</p> Signup and view all the answers

    What happens to the cilia when the mucus in the airways becomes dehydrated and thickens?

    <p>The cilia are flattened and unable to sweep properly. (D)</p> Signup and view all the answers

    How many amino acids make up the CFTR protein?

    <p>1,480 (D)</p> Signup and view all the answers

    What is the role of airway surface liquid (ASL) in maintaining airway health?

    <p>ASL dilutes mucus, facilitating its entrapment of bacteria and clearance. (B)</p> Signup and view all the answers

    How does the CFTR protein regulate the volume of ASL?

    <p>CFTR inhibits sodium absorption, preventing water from leaving the ASL. (C)</p> Signup and view all the answers

    What is the function of the CFTR protein?

    <p>It regulates the flow of chloride ions across cell membranes. (D)</p> Signup and view all the answers

    Which of the following is NOT a consequence of a defective CFTR protein?

    <p>Increased water layer on the surface of lung cells (B)</p> Signup and view all the answers

    What is the consequence of a malfunctioning CFTR protein in relation to ASL volume?

    <p>Decreased ASL volume. (A)</p> Signup and view all the answers

    What is the role of cilia in the lungs?

    <p>To remove debris from the airway (A)</p> Signup and view all the answers

    What are the primary consequences of depleted ASL volume in the airways?

    <p>Increased risk of bacterial infection and chronic inflammation. (C)</p> Signup and view all the answers

    Where is the CFTR gene located?

    <p>Chromosome 7 (C)</p> Signup and view all the answers

    Which of the following is NOT a common bacterial pathogen associated with cystic fibrosis lung infections?

    <p>Escherichia coli (D)</p> Signup and view all the answers

    What is the relationship between the CFTR protein and ATP binding cassette (ABC) proteins?

    <p>The CFTR protein is a type of ABC protein. (A)</p> Signup and view all the answers

    What is the primary reason for the development of digital clubbing in individuals with cystic fibrosis?

    <p>Reduced oxygen levels due to poor lung function. (A)</p> Signup and view all the answers

    Which of the following is NOT a symptom commonly observed in individuals with cystic fibrosis?

    <p>Muscle cramps (D)</p> Signup and view all the answers

    What is the underlying cause of cystic fibrosis (CF)?

    <p>A genetic mutation that affects the CFTR protein (B)</p> Signup and view all the answers

    What is the primary cause of centroacinar emphysema?

    <p>Cigarette smoke and nicotine (B)</p> Signup and view all the answers

    Which of these is NOT a characteristic of emphysema?

    <p>Increased lung capacity (C)</p> Signup and view all the answers

    What is the role of α1-antitrypsin in the lungs?

    <p>To inhibit the enzyme elastase (A)</p> Signup and view all the answers

    How does panacinar emphysema differ from centroacinar emphysema?

    <p>Panacinar emphysema is associated with α1-antitrypsin deficiency while centroacinar is linked to smoking. (D)</p> Signup and view all the answers

    What is the primary goal of biotransformation in the lungs?

    <p>To modify xenobiotics to facilitate their elimination. (B)</p> Signup and view all the answers

    What is the effect of nicotine on neutrophils in the context of emphysema?

    <p>Nicotine attracts neutrophils to the lungs and increases their activity. (A)</p> Signup and view all the answers

    Which of the following enzymes is NOT involved in Phase I reactions of biotransformation?

    <p>Glutathione S-transferase (D)</p> Signup and view all the answers

    What is the primary function of elastin in the lungs?

    <p>To prevent the alveoli from collapsing during exhalation (D)</p> Signup and view all the answers

    What is the primary mechanism by which Phase II reactions in biotransformation increase water solubility?

    <p>Conjugating with internal cellular molecules. (B)</p> Signup and view all the answers

    Which of the following best describes the process of metabolic bioactivation?

    <p>The conversion of a harmless substance into a reactive and potentially harmful form. (B)</p> Signup and view all the answers

    Which of the following enzymes plays a critical role in the development of emphysema?

    <p>Elastase (A)</p> Signup and view all the answers

    What is the main distinction between panacinar and centroacinar emphysema?

    <p>Panacinar emphysema affects the entire acinus while centroacinar primarily affects the center of the acinus. (A)</p> Signup and view all the answers

    What is the role of epoxide hydrolase (EH) in the bioactivation of benzo(a)pyrene?

    <p>EH converts BP-7,8-epoxide into BP-7,8-diol. (A)</p> Signup and view all the answers

    Which enzyme is responsible for the final step in the bioactivation of benzo(a)pyrene into a reactive form that can bind to DNA?

    <p>Cytochrome P450 (CYP1A1) (D)</p> Signup and view all the answers

    What is the major source of benzo(a)pyrene, a classic example of a pre-carcinogen activated by biotransformation?

    <p>Combustion products, including tobacco smoke (C)</p> Signup and view all the answers

    What is the significance of the bioactivation of benzo(a)pyrene in terms of human health?

    <p>It can lead to the formation of reactive species that damage DNA, potentially contributing to cancer. (B)</p> Signup and view all the answers

    Flashcards

    CYP Superfamily

    Group of enzymes responsible for the oxidative metabolism of xenobiotics and endogenous compounds.

    P450 Monooxygenases

    Enzymes that use molecular oxygen to oxidize substances, requiring NADPH for function.

    Phase I Metabolism

    First stage of xenobiotic metabolism, primarily through oxidation by P450 enzymes.

    Phase II Enzymes

    Enzymes that further modify metabolites from Phase I for elimination from the body.

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    Glutathione S-transferases (GSTs)

    Enzymes that catalyze the conjugation of glutathione to various compounds to detoxify them.

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    Obstructive Lung Diseases

    Conditions that impair airflow due to obstruction, examples include asthma and chronic bronchitis.

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    Restrictive Lung Diseases

    Conditions that restrict lung expansion, often caused by scarring or mechanical issues.

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    Xenobiotics

    Foreign substances not naturally produced in the body, including drugs and pollutants.

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    Biotransformation

    The process cells modify xenobiotics to eliminate them.

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    Phase I reactions

    Reactions that introduce new functional groups to xenobiotics.

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    Cytochrome P450

    A key enzyme involved in Phase I oxidation reactions.

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    Phase II reactions

    Reactions that conjugate compounds to increase water solubility.

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    Glutathione S-transferase

    An enzyme that catalyzes detoxification in Phase II reactions.

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    Metabolic bioactivation

    Process where harmless substances become reactive compounds.

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    Benzo(a)pyrene

    A carcinogen from tobacco smoke that is bioactivated in the body.

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    ARDS

    Acute respiratory distress syndrome, a serious lung condition characterized by hypoxemia and stiff lungs.

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    Three phases of ARDS

    Exudative, proliferative, and fibrotic phases that ARDS progresses through.

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    Exudative Phase

    The initial inflammatory stage of ARDS with cytokine release and neutrophil influx.

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    Proliferative Phase

    The stage characterized by a decrease in Type II pneumocytes and thickening of alveolar capillaries.

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    Fibrotic Phase

    The final stage in ARDS associated with collagen deposition and decreased lung compliance.

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    Signs of lung injuries

    Symptoms include dyspnea, tachypnea, and hypoxemia caused by various lung injuries.

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    Cyanosis

    Bluish discoloration of skin due to low oxygen levels in blood.

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    Direct lung injury causes

    Causes include pneumonia, smoke inhalation, drowning, and severe injury.

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    Emphysema

    A chronic lung condition characterized by loss of elastic recoil and air trapping in the alveoli.

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    Chronic Obstructive Pulmonary Disease (COPD)

    A group of irreversible lung diseases including emphysema and chronic bronchitis that impair breathing.

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    Types of Emphysema

    Emphysema is classified into panacinar, centroacinar, and congenital lobar based on location and cause.

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    Panacinar Emphysema

    A type of emphysema that affects all portions of the acinus, primarily in the lower lobes.

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    Alpha-1 Antitrypsin

    An enzyme that inhibits elastase to protect lung elastin from destruction; deficiency leads to emphysema.

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    Centroacinar Emphysema

    A type of emphysema affecting the bronchioles with less impact on external alveolar structures, often caused by smoking.

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    Elastase

    An enzyme secreted by neutrophils that destroys elastin in the lungs, contributing to emphysema.

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    Smoking and Emphysema

    Cigarette smoke elevates neutrophils and elastase leading to centroacinar emphysema in susceptible individuals.

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    Autosomal Recessive Inheritance

    A type of inheritance where two copies of a mutant gene must be present for a child to be affected.

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    CFTR Gene

    Gene responsible for cystic fibrosis located on chromosome 7, known for118 mutations.

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    Most Common CFTR Mutation

    The Δ F508 mutation accounts for 70% of CF alleles in Caucasians.

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    CFTR Protein Structure

    CFTR protein consists of 1,480 amino acids shaped like a tube, forming an ion channel.

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    Function of CFTR Protein

    Works as an ion channel moving chloride ions across the cell membrane.

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    Role of Chloride Ions

    Chloride ions attract water, essential for mucus balance and cilia movement in lungs.

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    Cilia Function in Lungs

    Tiny hairs that sweep mucus out of the airways, dependent on moisture from CFTR function.

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    Consequences of CFTR Dysfunction

    Failure to move chloride ions leads to mucus buildup causing cystic fibrosis symptoms.

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    Cilia function

    Cilia are hair-like structures that remove mucus from airways by sweeping.

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    Cystic fibrosis (CF)

    A genetic disorder that causes thick, sticky mucus buildup in lungs and other organs.

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    CFTR protein

    Cystic fibrosis transmembrane conductance regulator; regulates chloride and thiocyanate ions in cells.

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    Airway Surface Liquid (ASL)

    Fluid lining the airway that helps in mucus clearance and supports cilia movement.

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    ENaC channel

    Epithelial sodium channel; absorbs sodium in the airways, affecting fluid balance.

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    Mucin secretion

    The process of releasing mucin, which is essential for mucus consistency and trapping pathogens.

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    Bacterial infections in CF

    Chronic infections arise in CF due to thick mucus trapping bacteria.

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    Pulmonary symptoms of CF

    Common symptoms include cough, increased sputum, and recurrent pneumonia.

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    Digital clubbing

    A condition where fingers enlarge due to low oxygen levels in the body, often seen in CF patients.

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    Inflammation and obstruction

    CF leads to lung issues from inflammation and mucus blockage, impairing gas exchange.

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    Study Notes

    Metabolism and Bioactivation of Toxins in Pulmonary Tissue; α1-Antitrypsin Deficiency Syndrome

    • Alpha-1 antitrypsin protects lungs from proteases.
    • The liver releases alpha-1 antitrypsin into the blood.
    • Deficiency of alpha-1 antitrypsin leads to lung tissue damage.
    • Build-up of abnormal alpha-1 antitrypsin in the liver leads to liver cirrhosis.

    Biotransformation in Lungs

    • Lungs metabolize foreign compounds.
    • Biotransformation modifies xenobiotics for easier elimination.
    • The goal is to remove lipophilic substances that would accumulate in cell lipids.
    • This process is achieved by enzymes capable of introducing new functional groups (Phase I reactions) or conjugating them with internal molecules to enhance water solubility (Phase II reactions).

    Xenobiotic-Metabolizing Enzymes in Human Lung

    • Phase I reactions involve oxidation reactions catalyzed by cytochrome P450-dependent monooxygenases and flavin monooxygenases, and reductions catalyzed by P450 reductase.
    • Phase II reactions are catalyzed by GST (glutathione-S-transferase), UDP-glucuronyltransferase, epoxide hydrolase, sulphotransferase, and N-acetyltransferase.

    Scheme of Xenobiotic Detoxification

    • Phase I reactions convert xenobiotics into reactive electrophiles.
    • Phase II reactions detoxify the reactive electrophiles, making them more hydrophilic.
    • Reacts with proteins and DNA
    • These metabolites may be cleaved by enzymes in the kidney and colon to produce mutagens and carcinogens.
    • The final products are excreted.

    Metabolic Bioactivation

    • Biotransformation of foreign compounds can be beneficial for eliminating them.
    • However, it can also activate harmless substances into reactive forms, such as the metabolic activation of benzo(a)pyrene for binding to DNA and leading to cancer.
    • CYP450 enzymes are involved in the activation and subsequent detoxification of benzo[a]pyrene (B[a]P).

    Expression of P450 Enzymes in Pulmonary Tissue

    • P450 monooxygenases are responsible for the oxidative metabolism of xenobiotics, drugs, environmental pollutants, and carcinogens.
    • P450 enzymes utilize oxygen and NADPH-cytochrome P450 to oxidize xenobiotics and generate water.
    • CYP1A1, CYP1B1, CYP2B6, CYP2E1, CYP2J2, and CYP3A5 are expressed in the lung, bronchial epithelium, Clara cells, type II pneumocytes, and alveolar macrophages.

    Expression of Phase II Enzymes in Pulmonary Tissue

    • Phase II enzymes play a role in the elimination of metabolites.
    • GSTs, UGTs, and epoxide hydrolases are present in pulmonary tissue.
    • GSTs catalyze the conjugation of glutathione to a variety of endogenous and exogenous electrophilic compounds.

    Diseases of the Respiratory System

    • Non-infective diseases are grouped into obstructive and restrictive types.
    • Obstructive diseases include emphysema, chronic bronchitis, bronchiectasis, and asthma (impaired airflow).
    • Restrictive diseases involve restriction of lung expansion due to fibrosis.

    What is Emphysema?

    • Emphysema is characterized by loss of elastic recoil in the lungs.
    • This leads to increased compliance and the inability to expel air from the lungs.
    • Air gets trapped in the alveoli, which cluster together, forming blebs.
    • Emphysema is a form of COPD.

    Causes of COPD

    • Cigarette smoking, α1-antitrypsin deficiency, hypocomplementemic urticarial vasculitis, intravenous Ritalin abuse, Ehlers-Danlos syndrome, Marfan syndrome, Salla disease, α1-antichymotrypsin deficiency, and HIV (emphysema-like illness) are possible COPD causes.

    Classification of Emphysema

    • Emphysema is classified into panacinar and centrilobular types.
    • Panacinar emphysema involves all portions of the acinus and secondary pulmonary lobule uniformly, usually in the lower lobes.
    • Centrilobular emphysema primarily affects the respiratory bronchioles, usually in the upper lobes.

    Emphysema and α1-Antitrypsin

    • Elastin is a lung protein and the enzyme elastase, secreted by neutrophils, breaks it down.
    • α1-antitrypsin inhibits elastase to prevent the degradation of elastin and the damage seen in emphysema.
    • Deficiency of α1-antitrypsin, especially in smokers, leads to the destruction of lung tissue due to loss of elastin.

    Alpha-1 Antitrypsin Deficiency

    • In normal conditions, alpha-1 antitrypsin protects lungs from damage by enzymes.
    • In deficiency, alpha-1 antitrypsin is trapped in the liver, causing liver damage. In the lungs, neutrophil elastase is not inhibited; therefore, lung damage occurs.

    Centroacinar Emphysema

    • Centroacinar emphysema mainly affects the respiratory bronchioles.
    • Cigarette smoke containing nicotine contributes to this type of emphysema by acting as a major attractant for neutrophils.
    • Nicotine increases the activity of several pathways resulting in an increase in neutrophil activation and elastase.

    Bronchitis

    • Bronchitis involves inflammation of the bronchial mucus membranes.
    • It can be acute or chronic.
    • Acute bronchitis is usually caused by a temporary irritant like an infective agent (virus or bacteria) or an environmental irritant.
    • Cough and mucus production are common symptoms.

    Asthma

    • Asthma is a chronic respiratory inflammatory condition characterized by intermittent, variable, and partly reversible constriction of bronchiolar smooth muscles.
    • This can cause airway obstruction and result in difficulty breathing.
    • Severe cases result in obstruction that is difficult to treat and wheezes become silent.
    • The condition is associated with an inflammatory response and elevated immunoglobin E (IgE).

    Asthma

    • Asthma is associated with an inflammatory response causing the overproduction of IgE, which blocks beta-2 receptors in smooth muscles.
    • The beta-adrenergic theory of asthma explains the mechanism behind this condition.

    Asthma

    • Genetic and other variables can make cells in the bronchi hypersensitive to environmental triggers.
    • Environmental triggers stimulate an immune response (B-cell/helper T-cell (Th2) response) resulting in the production of antibodies to the trigger.
    • This can cause a hypersensitivity response resulting in IgE production from plasma cells, interacting with mast and basophil cells.

    Acute Respiratory Distress Syndrome (ARDS)

    • ARDS is a severe lung condition defined by hypoxemia and stiff lungs.
    • It occurs in response to various injuries and progresses through different phases.
    • The pathology of ARDS involves an exudative, proliferative, and fibrotic phase.

    Phases of ARDS

    • Exudative phase: inflammation, increased vascular permeability, neutrophil influx, decreased surfactant, and impaired endothelial cells.
    • Proliferative phase: decrease in type II pneumocytes, early fibrotic changes, and thickened alveolar capillaries.
    • Fibrotic phase: increased collagen deposition and decreased compliance.

    Lung Injuries and Symptoms

    • Direct lung injuries include pneumonia, breathing in smoke, use of ventilators, and nearly drowning.
    • Indirect lung injuries include sepsis, blood transfusions, severe chest injuries, severe bleeding, pancreatitis, fat embolism, and drug reactions.
    • Common symptoms of lung injuries include dyspnea, tachypnea, and hypoxemia. Severe cases might lead to hypotension, confusion, and cyanosis.

    Cyanosis

    • Cyanosis is the bluish discoloration of the skin and mucous membranes due to low oxygen levels in the blood.
    • It's caused by low oxygen levels in the red blood cells or difficulties in oxygenating the blood due to certain lung or heart conditions.

    Biochemical Basis of Lung Injuries

    • Inflammation is a crucial component in lung injuries, leading to increased vascular permeability, edema, neutrophil and macrophage influx, and damage to alveoli.
    • Impaired oxygen exchange, increased breathing rate, and respiratory acidosis are results of the inflammatory response.
    • Fibrous tissue deposition, collapse of alveoli, and decrease in compliance are caused by further inflammation and dysfunction of type II alveolar cells.

    Cystic Fibrosis (CF)

    • CF is an autosomal recessive multisystem disease caused by mutations in the CFTR gene.
    • Chronic sino-pulmonary disease, nutritional deficiency/GI abnormality, and electrolyte abnormality are commonly observed conditions in CF.

    Who is Affected by CF?

    • CF affects about one in 2,500 people of European descent.
    • Median survival is 25 years, and the number of patients reaching their 30s is increasing.

    Autosomal Recessive Inheritance in CF

    • CF is an autosomal recessive disorder.
    • If both parents carry the CFTR gene mutation, there is a 25% chance of a child inheriting the disease, and a 50% chance of being a carrier.

    Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) Gene

    • The CFTR gene is located on chromosome 7; the F508 mutation is common in Caucasians.
    • There are 1522 mutations identified in the CFTR mutation database.

    The Cystic Fibrosis Transmembrane Conductance Regulator (CFTR)

    • CFTR is a protein made of 1,480 amino acids forming a specific 3D structure.
    • It's a member of the ATP-binding cassette (ABC) superfamily.
    • The CFTR protein acts as an ion channel, moving chloride ions across epithelial membranes.

    What Does the CFTR Protein Do?

    • CFTR is an ion channel moving chloride ions from inside the cell to outside.
    • These chloride ions attract a water layer that helps cilia sweep away mucus.

    Disease-Causing Mutation Subclasses in Cystic Fibrosis

    • There are over 1700 CFTR mutations classified into 5 categories based on pathogenic mechanisms.
    • Some mutations are approved for treatment with CFTR modulators.
    • Different populations have different frequencies for specific mutations.

    How Do Problems With the CFTR Protein Cause CF?

    • Problems with the CFTR protein lead to the trapping of chloride ions inside the cell.
    • This reduces water outside the cell and causes the mucus to become dehydrated and thick, impairing ciliary function.
    • Mucus buildup obstructs airways, provides a breeding ground for bacteria, and causes infections.

    Airway Surface Liquid Low Volume Hypothesis

    • Clearance of mucus depends on ciliary function and secretion.
    • Optimal volume of airway surface liquid (ASL) facilitates bacteria entrapment.
    • ASL volume is regulated by the absorption of Na+ ions and secretion of Cl- ions.
    • Defects in CFTR reduce Cl- secretion, decreasing ASL volume.

    Airway Surface Liquid Low Volume Hypothesis and CFTR

    • Normal CFTR inhibits sodium channels (ENaC).
    • This inhibition reduces sodium absorption, which has a downstream effect on ASL volume.
    • In CF, mutant CFTR does not inhibit ENaC properly, increasing sodium absorption and reducing ASL volume.
    • This reduced ASL volume leads to poor mucociliary clearance, accumulation of mucus, and increased bacterial infection risk.

    Airway Surface Liquid Low Volume Hypothesis and Consequences

    • Depleted ASL volume negatively affects ciliary function, impairing mucus clearance.
    • This results in concentrated mucus that adheres to the airway surface, increasing the susceptibility to chronic infections.

    CF Lung Pathophysiology

    • Diminished host defenses lead to recurring bacterial infections.
    • Common bacterial pathogens in CF include Pseudomonas aeruginosa, Staphylococcus aureus, Haemophilus influenzae, and Burkholderia cepacia.
    • The subsequent inflammation, infection, and obstruction lead to bacterial toxins, impaired gas exchange, and chronic respiratory failure.

    CF Symptoms

    • Pulmonary Symptoms: cough, increased sputum production, recurrent pneumonia, and digital clubbing.
    • Gastrointestinal Symptoms: pancreatic enzyme insufficiency, fat-soluble vitamin deficiency, and malnutrition.

    Diagnosis-Sweat Chloride

    • Sweat chloride tests are used to diagnose cystic fibrosis.
    • Elevated sweat chloride levels (60-165 meq/L) indicate cystic fibrosis.

    Prenatal Screening

    • The American College of Obstetricians and Gynecologists recommends carrier testing for CF mutations during pregnancy.
    • Testing sensitivity for CF among the white population is relatively low (~78%).
    • The testing sensitivity is lower in racial and ethnic minority populations.

    Cystic Fibrosis-Treatment is Multidisciplinary

    • Treatment of cystic fibrosis requires a multidisciplinary approach.
    • Key components include airway clearance, infection management, nutritional support, gastrointestinal care, inflammation management, and fertility counseling, as well as social support.

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